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Abstract

In 1964, the first Report of the Surgeon General of the United States concluded that cigarette smoking caused, or contributed to, many serious diseases, including lung cancer. Public health efforts to reduce tobacco use have had substantial success, but today, almost one-quarter of all Americans smoke and more than four hundred thousand Americans die yearly from tobacco use. It is clear that current public health efforts must be expanded. Despite our best efforts, it is also likely that many Americans will continue to start smoking, while others will be unable or unwilling to quit. Therefore, it is appropriate to ask what, if anything, can be done to reduce the harm suffered by those who continue to use tobacco.